Andrassy K, Ritz E
Medizinische Universitätsklinik Heidelberg, Sektion Nephrologie.
Ther Umsch. 1994 Dec;51(12):813-8.
The diagnosis of Wegener's granulomatosis, microscopic polyarteritis and idiopathic rapidly progressive glomerulonephritis as the main cause of renal involvement in systemic necrotizing vasculitis was revolutionized following the introduction of the ANCA test. The different clinical manifestations of these diseases are described. By means of the ANCA test it could be demonstrated that the pulmonary-renal syndrome was mainly caused by these vasculitides and not by Goodpasture's syndrome. Cyclophosphamide and steroids remain the drugs of choice in the treatment. They can be administered in different ways depending upon the clinical manifestation of the diseases. As therapeutic alternatives cyclosporin, trimethoprim/sulfamethoxazole, intravenous immunglobulins and monoclonal antibodies are discussed.
抗中性粒细胞胞浆抗体（ANCA）检测的引入，彻底改变了韦格纳肉芽肿、显微镜下多血管炎和特发性快速进展性肾小球肾炎作为系统性坏死性血管炎累及肾脏主要病因的诊断。文中描述了这些疾病的不同临床表现。通过ANCA检测可以证明，肺肾综合征主要由这些血管炎引起，而非由古德帕斯彻综合征所致。环磷酰胺和类固醇仍然是治疗的首选药物。可根据疾病的临床表现以不同方式给药。文中还讨论了环孢素、甲氧苄啶/磺胺甲恶唑、静脉注射免疫球蛋白和单克隆抗体作为治疗替代方案的情况。
